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Haszard JJ, Heath ALM, Taylor RW, Bruckner B, Katiforis I, McLean NH, Cox AM, Brown KJ, Casale M, Jupiterwala R, Diana A, Beck KL, Conlon CA, von Hurst PR, Daniels L. Equations to estimate human milk intake in infants aged 7 to 10 months: prediction models from a cross-sectional study. Am J Clin Nutr 2024:S0002-9165(24)00399-X. [PMID: 38890036 DOI: 10.1016/j.ajcnut.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Obtaining valid estimates of nutrient intake in infants is currently limited by the difficulties of accurately measuring human milk intake. Current methods are either unsuitable for large-scale studies (i.e., the gold standard dose-to-mother stable isotope technique) or use set amounts, regardless of known variability in individual intake. OBJECTIVES This cross-sectional study aimed to develop equations to predict human milk intake using simple measures and to carry out external validation of existing methods against the gold standard technique. METHODS Data on human milk intake were obtained using the dose-to-mother stable isotope technique in 157 infants aged 7-10 mo and their mothers. Predictive equations were developed using questionnaire and anthropometric data (Model 1) and additional dietary data (Model 2) using lasso regression. Bland-Altman plots and intraclass correlation coefficients (ICC) also assessed the validity of existing methods (FITS and ALSPAC studies). RESULTS The strongest univariate predictors of human milk intake in infants of 8.3 mo on average (46% female) were infant age, infant body mass index (BMI), number of breastfeeds a day, infant formula consumption, and energy from complementary food intake. Mean [95% confidence interval (CI)] differences in predicted versus measured human milk intake [mean (SD): 762 (257) mL/day] were 0.0 mL/day (-26, 26) for Model 1 (ICC 0.74) and 0.5 mL/day (-21, 22) for Model 2 (ICC 0.83). Corresponding differences were -197 mL/day (-233, -161; ICC 0.32) and -175 mL/day (-216, -134; ICC 0.41) for the methods used by FITS and ALSPAC, respectively. CONCLUSIONS The Human Milk Intake Level Calculation provides substantial improvements on existing methods to estimate human milk intake in infants aged 7-10 mo, while utilizing data commonly collected in nutrition surveys. Although further validation in an external sample is recommended, these equations can be used to estimate human milk intake at this age with some confidence. This clinical trial was registered at http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379436) as ACTRN12620000459921.
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Affiliation(s)
| | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Bailey Bruckner
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Neve H McLean
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Alice M Cox
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Kimberley J Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Maria Casale
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Aly Diana
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin, New Zealand.
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McLean NH, Haszard JJ, Daniels L, Taylor RW, Wheeler BJ, Conlon CA, Beck KL, von Hurst PR, Te Morenga LA, McArthur J, Paul R, Katiforis I, Brown KJ, Gash MC, Rowan MM, Casale M, Cox AM, Jones EA, Jupiterwala RM, Bruckner B, Fleming L, Heath ALM. Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study. Nutrients 2024; 16:1494. [PMID: 38794732 PMCID: PMC11124519 DOI: 10.3390/nu16101494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.
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Affiliation(s)
- Neve H. McLean
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
| | | | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (L.D.); (R.W.T.); (J.M.); (A.M.C.)
| | - Rachael W. Taylor
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (L.D.); (R.W.T.); (J.M.); (A.M.C.)
| | - Benjamin J. Wheeler
- Department of Women’s and Children’s Health, University of Otago, Dunedin 9016, New Zealand;
| | - Cathryn A. Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Kathryn L. Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Pamela R. von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Lisa A. Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington 6140, New Zealand;
| | - Jenny McArthur
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (L.D.); (R.W.T.); (J.M.); (A.M.C.)
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
| | - Kimberley J. Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Madeline C. Gash
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
| | - Madeleine M. Rowan
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
| | - Maria Casale
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Alice M. Cox
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (L.D.); (R.W.T.); (J.M.); (A.M.C.)
| | - Emily A. Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Rosario M. Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (C.A.C.); (K.L.B.); (P.R.v.H.); (R.P.); (K.J.B.); (M.C.); (E.A.J.); (R.M.J.)
| | - Bailey Bruckner
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
| | - Liz Fleming
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
| | - Anne-Louise M. Heath
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (N.H.M.); (I.K.); (M.C.G.); (M.M.R.); (B.B.); (L.F.)
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Haszard JJ, Heath ALM, Katiforis I, Fleming EA, Taylor RW. Contribution of Infant Food Pouches and Other Commercial Infant Foods to the Diets of Infants: A Cross-sectional Study. Am J Clin Nutr 2024; 119:1238-1247. [PMID: 38431120 DOI: 10.1016/j.ajcnut.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/14/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Although considerable concern has been expressed about the nutritional implications of infant food pouches, how they impact infant diet has not been examined. OBJECTIVES The objective of this study was to determine the contribution of infant food pouches specifically, and commercial infant foods generally, to nutrient intake from complementary foods in infants. METHODS Two multiple-pass 24-h diet recall data were collected from 645 infants (6.0-11.9 mo) in the First Foods and Young Foods New Zealand studies. Detailed information was obtained on commercial infant food use, including pouches, and nutrient composition was calculated through recipe modeling. RESULTS The diverse sample (46.1% female; 21.1% Māori, 14.1% Asian, and 54.6% European) was aged (SD) 8.4 (0.9) mo. More than one-quarter of households had high socioeconomic deprivation. Almost half (45.3%) of infants consumed an infant food pouch on ≥1 recall day [mean (SD), 1.3 (0.9) times/d], obtaining 218 (124) kJ of energy on each eating occasion. Comparable numbers for all commercial infant and toddler foods (CITFs) were 78.0%, contributing 2.2 (1.6) and 140 (118) kJ of energy. Infant food pouches provided 25.5% of the total energy from complementary foods in those infants who consumed pouches on the recall days but just 11% in all infants. Median percentage contribution of infant food pouches to nutrient intake from complementary foods in consumers ranged from <1% (added sugars and retinol) to >30% (carbohydrate, total sugars, fiber, vitamin A, and vitamin C). CITF contributed 21.4% of energy from complementary foods for infant consumers, with median percentage contribution ranging from 0.1% (retinol) to 40.3% (iron). CONCLUSIONS Infant food pouches make relatively small contributions to energy intake in infants but are important sources of carbohydrates, fiber, and vitamins A, C, and B-6. Almost half of the total sugars consumed from complementary foods is provided by these pouches. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12620000459921.
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Affiliation(s)
| | | | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.
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4
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Cox AM, Taylor RW, Haszard JJ, Beck KL, von Hurst PR, Conlon CA, Te Morenga LA, Daniels L, McArthur J, Paul R, McLean NH, Jones EA, Katiforis I, Brown KJ, Gash M, Rowan M, Fleming EA, Jupiterwala R, Bruckner BR, Heath ALM. Baby food pouches and Baby-Led Weaning: Associations with energy intake, eating behaviour and infant weight status. Appetite 2024; 192:107121. [PMID: 37972656 DOI: 10.1016/j.appet.2023.107121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Although concern is frequently expressed regarding the potential impact of baby food pouch use and Baby-Led Weaning (BLW) on infant health, research is scarce. Data on pouch use, BLW, energy intake, eating behaviour and body mass index (BMI) were obtained for 625 infants aged 7-10 months in the First Foods New Zealand study. Frequent pouch use was defined as ≥5 times/week during the past month. Traditional spoon-feeding (TSF), "partial" BLW and "full" BLW referred to the relative proportions of spoon-feeding versus infant self-feeding, assessed at 6 months (retrospectively) and current age. Daily energy intake was determined using two 24-h dietary recalls, and caregivers reported on a variety of eating behaviours. Researchers measured infant length and weight, and BMI z-scores were calculated (World Health Organization Child Growth Standards). In total, 28% of infants consumed food from pouches frequently. Frequent pouch use was not significantly related to BMI z-score (mean difference, 0.09; 95% CI -0.09, 0.27) or energy intake (92 kJ/day; -19, 202), but was associated with greater food responsiveness (standardised mean difference, 0.3; 95% CI 0.1, 0.4), food fussiness (0.3; 0.1, 0.4) and selective/restrictive eating (0.3; 0.2, 0.5). Compared to TSF, full BLW was associated with greater daily energy intake (BLW at 6 months: mean difference 150 kJ/day; 95% CI 4, 297; BLW at current age: 180 kJ/day; 62, 299) and with a range of eating behaviours, including greater satiety responsiveness, but not BMI z-score (6 months: 0.06 (-0.18, 0.30); current age: 0.06 (-0.13, 0.26)). In conclusion, neither feeding approach was associated with weight in infants, despite BLW being associated with greater energy intake compared with TSF. However, infants who consumed pouches frequently displayed higher food fussiness and more selective eating.
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Affiliation(s)
- Alice M Cox
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | | | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Lisa A Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Jenny McArthur
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Neve H McLean
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Emily A Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Kimberley J Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Madeline Gash
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | | | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Bailey R Bruckner
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
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Brown KJ, Beck KL, von Hurst P, Heath AL, Taylor R, Haszard J, Daniels L, Te Morenga L, McArthur J, Paul R, Jones E, Katiforis I, Rowan M, Casale M, McLean N, Cox A, Fleming E, Bruckner B, Jupiterwala R, Wei A, Conlon C. Adherence to Infant Feeding Guidelines in the First Foods New Zealand Study. Nutrients 2023; 15:4650. [PMID: 37960303 PMCID: PMC10647304 DOI: 10.3390/nu15214650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Infant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health "Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)". Data were obtained from First Foods New Zealand, a multicentre observational study of 625 infants aged 7.0-10.0 months. Caregivers completed two 24-h diet recalls and a demographic and feeding questionnaire. Nearly all caregivers (97.9%) initiated breastfeeding, 37.8% exclusively breastfed to around six months of age, and 66.2% were currently breastfeeding (mean age 8.4 months). Most caregivers met recommendations for solid food introduction, including appropriate age (75.4%), iron-rich foods (88.3%), puréed textures (80.3%), and spoon-feeding (74.1%). Infants consumed vegetables (63.2%) and fruit (53.9%) more frequently than grain foods (49.5%), milk and milk products (38.6%), and meat and protein-rich foods (31.8%). Most caregivers avoided inappropriate beverages (93.9%) and adding salt (76.5%) and sugar (90.6%). Our findings indicated that while most infants met the recommendations for the introduction of appropriate solid foods, the prevalence of exclusive breastfeeding could be improved, indicating that New Zealand families may need more support.
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Affiliation(s)
- Kimberley J. Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Kathryn L. Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Pamela von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Anne-Louise Heath
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Jillian Haszard
- Biostatistics Centre, University of Otago, Dunedin 9016, New Zealand;
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington 6140, New Zealand;
| | - Jenny McArthur
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Emily Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Maria Casale
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Neve McLean
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Alice Cox
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Elizabeth Fleming
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Bailey Bruckner
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Andrea Wei
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Cathryn Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
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Arslan N, Kurtuncu M, Turhan PM. The effect of baby-led weaning and traditional complementary feeding trainings on baby development. J Pediatr Nurs 2023; 73:196-203. [PMID: 37714048 DOI: 10.1016/j.pedn.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE The aim of this study was to evaluate the risks of self-feeding, transition to early solid food and family meals, choking risk, anemia risk and obesity risk in 6-12-month-old infants who were introduced to complementary feeding using the traditional complementary feeding (TCF) and baby-led weaning (BLW) methods/training. DESIGN AND METHODS Mothers of infants who had not yet transitioned to complementary feeding were included in this randomized study. The mothers of 62 infants included in the study were randomized into the intervention groups as TCF and BLW, classified according to the number of children and education level. The research was carried out according to the CONSORT-2010 guidelines after randomization and was concluded with 52 infants and their mothers. RESULTS It was found in the study that self-feeding and transition to solid foods in infants fed with the BLW method was higher than the infants fed with the TCF method (p < 0.05). A significant increase was observed in the hemoglobin level of infants fed with the BLW method over time (p < 0.001). CONCLUSIONS It was concluded that the BLW method did not lead to risks of obesity, anemia and iron deficiency in transition to complementary feeding. Secondary results indicated that feeding with the BLW method promoted self-feeding and early transition to solid foods and did not lead to the risk of choking. PRACTICE IMPLICATIONS Complementary feeding with the BLW method can be safely used by both mothers, healthcare professionals and researchers. TRIAL REGISTRATION register. CLINICALTRIALS gov; Identifier: NCT05771324.
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Affiliation(s)
- Nurten Arslan
- Department of Pediatric Nursing, Faculty of Health Sciences, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.
| | - Meltem Kurtuncu
- Department of Pediatric Nursing, Faculty of Health Sciences, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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7
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Fredriksson E, Bodén S, Domellöf M, West CE. Fruit Pouch Consumption Does Not Associate with Early Manifestations of Allergic Disease. Nutrients 2023; 15:4318. [PMID: 37892394 PMCID: PMC10609626 DOI: 10.3390/nu15204318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Consumption of acidic fruit pouches in infancy may damage the epithelial barrier in the gastrointestinal tract and is suggested to increase allergy risk. We aimed to explore if a high fruit pouch consumption is associated with a higher incidence of early allergic manifestations. We included 2959 parent-child dyads from the Swedish prospective, population-based NorthPop birth cohort study with parentally reported data on frequency of fruit pouch consumption at 9 months of age, as well as parentally reported eczema, wheeze, physician-diagnosed asthma, and food allergy in the first 18 months of life. Immunoglobulin E levels (IgE) in serum (n = 1792), as response to a food mix and an inhalant mix, were determined at age 18 months. Compared with no consumption, daily consumption of one or more pouches at 9 months of age was associated with inhalant sensitization (odds ratio (OR) 2.27, 95% confidence interval (CI) 1.06-4.87, n = 1792) but did not remain significant in the multivariable adjusted model (aOR 2.08, 95% CI 0.95-4.53, n = 1679). There were no associations between fruit pouch consumption and allergic manifestations at this young age. This study suggests that fruit pouch consumption is not associated with allergic phenotypes or IgE sensitization in early childhood.
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Affiliation(s)
| | | | | | - Christina E. West
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 90185 Umeå, Sweden; (E.F.); (S.B.); (M.D.)
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Tournier C, Forde CG. Food oral processing and eating behavior from infancy to childhood: evidence on the role of food texture in the development of healthy eating behavior. Crit Rev Food Sci Nutr 2023:1-14. [PMID: 37267128 DOI: 10.1080/10408398.2023.2214227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Eating behaviors develop in early life and refine during childhood, shaping long-term food choice and dietary habits, which underpin optimum growth and health. The development of Food Oral Processing (FOP) is of major importance in the establishment of eating behaviors at two scale levels: for the initial acceptance of food texture and for the longer-term development of eating behaviors associated to food intake. To date, both processes have been studied as independent topics and the current review proposes a parallel vision on their development from the onset of complementary feeding to later childhood. Individual factors affecting these FOP-related behaviors as they relate to food texture acceptance are discussed, alongside examples of interventions aiming at modifying them. Opportunity to better consider food textures when designing foods for children is addressed. Altogether, the review demonstrates the critical role of food texture in the development of a child's FOP skills, eating habits, and dietary patterns. These scientific knowledges need to be considered for the development of healthier eating behavior. We identify research gaps that need to be addressed and highlight the need to design foods that can support the development of healthy oral processing and eating behaviors among infants and children.
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Affiliation(s)
- Carole Tournier
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, Dijon, France
- INRAE, PROBE Research Infrastructure, ChemoSens Facility, Dijon, France
| | - Ciaran G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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Rowan M, Mirosa M, Heath ALM, Katiforis I, Taylor RW, Skeaff SA. A Qualitative Study of Parental Perceptions of Baby Food Pouches: A Netnographic Analysis. Nutrients 2022; 14:nu14153248. [PMID: 35956424 PMCID: PMC9370201 DOI: 10.3390/nu14153248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022] Open
Abstract
Globally, a recent phenomenon in complementary feeding is the use of squeezable baby food pouches. However, some health agencies have raised concerns about their possible long-term health effects. The aim of this study was to describe parental perceptions of the use of baby food pouches during complementary feeding (i.e., the transition from an entirely milk-based diet to solid foods) using a netnographic analysis of discussions on publicly available forums. In this study, the community was parents of young children. Six parenting forums were identified through a Google search using defined selection criteria. Discussion threads relating to baby food pouches were collected and imported into NVivo12 for thematic analysis via inductive reasoning. Perceptions of baby food pouches fell within two broad categories—benefits and concerns. The most commonly reported themes related to benefits were: convenience, health, baby enjoys, variety, and cost; whereas the most common concerns reported were: health, cost, lack of dietary exposure, dependence, and waste. Many parents reported both benefits and concerns. Once research has determined the long-term effect of using pouches on infants’ health regarding eating habits, nutritional status, growth, and development, the findings of this study can inform educational strategies to either encourage or discourage their use.
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Affiliation(s)
- Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
| | - Miranda Mirosa
- Department of Food Science, University of Otago, Dunedin 9054, New Zealand
| | | | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
| | - Rachael W. Taylor
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand
| | - Sheila A. Skeaff
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
- Correspondence: ; Tel.: +643-479-7944
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